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Can't communicate fluently?  Try Speech and Language therapy

By Carol Aloysius

Communicating with one another has never been so important as it is today. Whether by talking to one another, or expressing our feelings on paper, the need to connect is vital in a world where an increasing number of persons, both young and old, are cut off from the rest of society simply because they are unable to communicate effectively.

The problems that cause this communication breakdown may be as simple as a stutter, or as in the case of those with aphasia, inability to recall something that is right there at the tip of their tongues.

While the ability to communicate comes naturally to most people, starting in infancy when a baby communicates his need for food by crying, to the toddler who uses body language and draws on his limited vocabulary to convey his feelings, there are others who are not so lucky. For these persons, speech impediments caused by a cleft palate, or brain damage or can make communication much more challenging a task. Unless given the right support with early intervention and the correct tools to deal with this particular speech deficiencies, it could end up with such persons becoming frustrated, developing mental problems and withdrawing into an isolated world of their own.

Rasangi Weerasekera, Speech and Language Therapist at the Sri Jayewardenepura General Hospital fielded questions from the Sunday Observer to explain how persons in her area of speciality can help people with speech impediments and to overcome their problems.

Excerpts...

Q. Speech and Language Therapy is a relatively new field in this country. Since many people are not familiar with this field could you first tell us what it means?

A. Speech and language therapy is a growing profession in Sri Lanka which will help you and your loved ones to overcome, manage and bridge barriers through facilitating effective communication. A speech disorder is a problem with fluency, voice and /or speech sounds of a person which results with unclear speech.

A fluency disorder is an interruption in the flow or rhythm of speech characterised by hesitation, repetitions or prolongations of sounds, syllables, words or phrases as in the case of stammering, or inappropriate rate/pace of speech as in cluttering. Also connected with it is articulation and phonological disorders i.e. the difficulties or variations with the way sounds are formed and strung together.

Q. So what is language disorder?

A. It is a problem with understanding and /or using spoken, written and other symbol systems (i.e. gestures, signs etc).

The disorder may involve 1) the form of the language (phonology, morphology, syntax) and 2) the content of the language (semantics) and function of language (pragmatics) on communication in any combination.

Q. What is the task of a Speech and Language therapist in this field?

A. Speech and language therapists are professionals with specialised knowledge and skills who can diagnose, evaluate and provide clinical services encompassing a range of communication (speech, language, voice and fluency) and swallowing difficulties to people of all ages, thus enabling them to function to the best of their ability.

Q. So they work with other related specialities or on their own?

A. They work in close liaison with ENT, neurology, and paediatric health professionals, and with professionals in the education field.

Q. Where can you access their help?

A. You may access Speech and language therapy services in a variety of settings including government and private hospitals, medical rehabilitation facilities, pre-schools, mainstream and special schools, and private practice settings.

Q. Why do you think the ability to communicate is important to us?

A. Being able to communicate is of paramount importance to everyone.

However unfortunately, it is not uncommon for children as well as adults to experience problems in communication. In fact, understandably it must be overwhelming for persons to function in their day to day lives when communication with loved ones, peers and superiors does not come as easily.

Q. So how does Speech and Language therapy help?

A. By bridging barriers through facilitating effective communication. As I said earlier, Speech and language therapists are professionals with specialised knowledge and skills who can diagnose, evaluate and provide clinical services encompassing a range of communication (speech, language, voice and fluency) and swallowing difficulties to people of all ages, thus enabling them to function to the best of their ability.

Q. Do you use similar methods for children and adults?*

A. The methods used for children is different from those used on adults.

For one thing, children are still acquiring speech whereas in the case of adults who have lost their speech due to stroke, dementia, Parkinson's disease etc, already had these skills and we only need to rehabilitate them.. In the case of children we call it habilitation - i.e. helping them to develop language and speech capacities with simulative activities.

Which is why we tell their parents that they must interact with their children from infancy especially those with speech and language problems, and not put them in front of the TV. which is certainly not the answer.

Furthermore, exploring the field of communication disorders, firstly, speech and language difficulties in children may present merely as a common developmental delay.

Nevertheless it is advisable that parents seek help and receive adequate support about how best to enrich the communication environment for their children in order to stimulate speech and language acquisition.

Q. How do speech and language difficulties manifest themselves?

A. Speech and language difficulties in both children and adults may often manifest secondary to developmental disorders, impaired hearing, autism, syndromic conditions such as Down syndrome, learning difficulties, cleft lip and cleft palate, and neurological conditions such as stroke, Parkinsonism, cerebral palsy, traumatic brain injury etc. Voice problems may also cause worry and apprehension among many occupational voice users such as teachers, lecturers, clergy and singers.

Q. What is the kind of therapy given them?

A. Usually it is not just one method, but many methods adapted to the person's needs and abilities. A Speech and language therapist would first conduct a comprehensive evaluation and implement abilities. It is not only the techniques that count. There are also underlying problems such as anxieties, fears, low esteem that need to be addressed when you treat a person with speech and language problems. All of them have to be addressed as well or else the patient can suffer from frustration and mental problems and have a low self esteem.

Q. What about stammers? Do your methods help to cure them?

A. With regard to communication, stammering is the most common reason for dysfluency or disrupted forward flow of speech. It is however common for children to stammer till they are about five years old. But if this condition continues into their adulthood it is often not easy to cure them... But we use various approaches and techniques such as breathing techniques, easy onset and flowing (to make the words flow) etc to help them.

Q. Why is correct breathing so important to overcome a speech impediment?

A. It is important to note that speech is not only limited to the mouth area.

To breathe correctly one must breathe from the diaphragm. People who are tense don't breathe properly using only a small portion of their lungs.

Using diaphragmatic breathing will help them create more space in their chest cavity for the lungs to expand. It is important to understand that although there is as yet no cure, stammering can nevertheless be successfully managed with proper support.

Q. In addition to communication, some people also have swallowing disorders. What is the cause for such disorders? Can Speech and Language therapy help them as well?

A. Swallowing disorders is another broad area where speech and language therapists practice clinical services. Swallowing difficulties [RNA3]; most commonly arise as a result of stroke, and neurological degenerative conditions as well as head and neck surgery.

Q. Have you any advice to give our readers?

A. Early systematic intervention is always the best for better outcomes in communication, literacy and cognition, as well as swallowing. This applies to both children and adults.

Consequently, the ultimate goal of Speech and language therapy is to enhance lifelong well-being of all those who are affected with communication and swallowing difficulties.

As I treat mostly adults, I have found that in the case of people who have suffered stroke where the language area can be damaged, the first six months is critical for intervention.

Q. Why?

A. Because the neural-connections adapt quickly. So we need to treat them with effective techniques to overcome the problem before the brain gets accustomed to maladaptive ways.

The role of the therapist is to use therapy along with other options that can strengthen their existing skills.

Freshwater turtles from wetlands can transmit Salmonella to humans

Following studies of 200 specimens of freshwater turtles from 11 Valencian wetland areas, to determine the prevalence of Salmonella and Campylobacter in these animals, Professors from the University CEU Cardenal Herrera explained of a potential risk of the turtles transmitting gastrointestinal diseases to humans, especially children. According to the results, 11 percent of the analysed specimens of freshwater turtles were found positive for Salmonella.

However, Campylobacter was not detected in any of them. This is the first study to rule out terrapins as transmitters of campylobacteriosis to humans. The research group has used specimens of the native Emys orbicularis and of the exotic species Trachemys scripta elegans, found in eleven wetlands of the Valencian Region (Spain), including the marshes of Pego-Oliva, Xeraco, Cabanes or Peníscola, among others.

In eight of the eleven wetlands the researchers found terrapins carriers of the bacteria Salmonella with moderate prevalence but none with the Campylobacter bacteria.

As pointed out by Prof of Veterinary Clara Marín, who led the study, campylobacteriosis and salmonellosis are common infections in humans: there have been 212,064 cases of the first and 99,020 cases of the second registered in the European Union during past year. Moreover, both are the two most frequent zoonosis worldwide, and thus represent an important public health problem in many countries which are interested in designing methods of preventing transmission of these infections from animals to humans. Salmonella can cause human gastroenteritis and meningitis, especially in children and elderly. Complications of campylobacteriosis can lead to arthritis and other diseases.

While previous studies had confirmed the risk of transmitting Salmonella in the case of pet turtles, in higher percentages than those recorded in this research, there are few studies on wild ones.

The project of the University CEU Cardenal Herrera is the first to extend the analysis to the prevalence of Campylobacter in these wild animals. Another novel aspect of the study was the combination of three different samples. The work has shown that collecting water samples where the turtles have remained for 48 hours after capture is as effective as sacrificing them or taking swabs directly from the rectum. This finding is especially helpful for sampling protected species.

- MNT

Medication with allergist can help lessen asthma attacks

Can't find relief from your asthma symptoms? The way you communicate with your allergist can be the root of your problems.

According to two papers published in Annals of Allergy, Asthma and Immunology, for treatment to be effective, asthma sufferers need to ask questions and feel as if they have open communication with their allergist.

"When patients do not understand their condition or treatment plan, they may not follow life-saving guidelines, putting them at increased risk for asthma attacks," said allergist Stanley Fineman, article author. "Changes need to be made by allergists and patients to ensure a treatment plan is in place that will be followed. Proper treatment and adherence to the plan not only improves quality of life, but may save lives."

Dr. Fineman noted that only eight to 13 percent of asthma sufferers continue to refill inhaled corticosteroid prescriptions after one year. Taken early and as directed, these inhalers can improve asthma control, normalise lung function and even prevent irreversible injury to airways. Asthma is responsible for 4,000 deaths annually, according to ACAAI. The number of Americans with asthma grows every year, and currently affects 26 million Americans.

The greatest rise in asthma rates is among African American children, which doubled from 2001 to 2009. "Our research found many African American asthma sufferers believed they had a better understanding of their asthma triggers and treatment as they reached young adulthood," said allergist Alan Baptist, MD, and senior study author. "However, many do not manage their condition as advised, which can lead to increased asthma attacks and emergency room visits.

Allergists need to communicate the importance of continuing medication, and patients should express any concerns they might have, such as taking medication in public, since there are often solutions. Additionally, providing adequate education and addressing specific barriers that young African American adults have in asthma management may decrease health care disparities and improve outcomes."

Although symptoms can become better with time, asthma is a chronic illness.

Unless directed by a physician, asthma patients should never change or discontinue preventive medications, and should always keep an adequate supply available.

"Asthma is a serious disease and discontinuing treatment can be dangerous," said Dr. Fineman. "Sufferers need to be sure they regularly take medication and that all of their concerns are being addressed."

- MNT